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3 charged with insurance fraud in national investigation

Georgia residents and others around the nation go to healthcare providers for medical needs. In many cases, the process is standard: services are provided to a patient, paperwork is filed by the facility, then providers receive payment from insurance companies for the services. However, insurance fraud can occur when claims are filed for ineligible services or for those not actually provided. Three medical personnel from Georgia were among a large number of people recently accused of health care fraud.

According to the country's Department of Health and Human Services, 412 people were charged with fraud in a federal investigation. Officials state that approximately $1.3 billion in fraudulent billing was allegedly discovered. In Georgia, almost $1.5 million in fraudulent claims were filed.

The indictment states that the owner and operator of the Georgia Center for Health, Wellness and Recover, a licensed psychologist in DeKalb County, submitted the claims to Medicaid. Reportedly, another worker at the clinic was also accused of similar charges. The facility provides mental health and substance rehab services. Another person from South Georgia was apparently involved in the case. However, no details were available about them.

The investigation has led to the largest number of arrests in a health care fraud case in the country. Officials hope to stem what they call a violation of the oaths taken by medical personnel. Government agencies contend that the alleged actions have been made at the expense of the taxpayers.

When someone is charged with insurance fraud in Georgia, that person has the right to present a defense. An experienced criminal defense attorney can work with clients to determine how to proceed in the process. A knowledgeable attorney will evaluate the evidence against a client and develop the best possible defense that will minimize any negative impact on someone's life.

Source: The Atlanta Journal-Constitution, "DeKalb psychologist charged with Medicaid fraud in national crackdown", Alexis Stevens, July 13, 2017

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